ABSTRACT
Secondary spontaneous pneumothorax almost always develops secondary to an underlying lung disease. A pneumothorax secondary to a malignancy is very rare, and is observed most frequently in soft tissue sarcomas. Pazopanib, a tyrosine kinase inhibitor, is used in metastatic soft tissue sarcomas treatment. The rate of pneumothorax that is caused by pazopanib is about 14% in the literature. The patient being presented in this article underwent surgery for soft tissue sarcoma, postoperatively received pazopanib (Votrient® 400 mg, oral, Glaxo Group Ltd, Brentford, UK) treatment due to widespread bilateral lung metastases, and developed synchronous spontaneous pneumothorax.
ABSTRACT
BACKGROUND/AIM: Mediastinoscopy is an invasive procedure that is used in the diagnosis of mediastinal diseases and in staging lung cancer. Tumor cell seeding during mediastinoscopy along the mediastinum and the incision line is a very rare complication. This study aimed to test the safety of mediastinoscopy in terms of tumor seeding by cytological evaluation of mediastinal lavage samples taken before and after biopsy. MATERIALS AND METHODS: The patients who underwent mediastinoscopy in our hospital between 2011 and 2014 were studied prospectively. Seventy-three patients with a diagnosis of lung or mediastinal malignancy were included in the study. All patients underwent classical cervical mediastinoscopy and mediastinal lavages were taken before and after the biopsy. Both lavage samples were sent to the pathology department in syringes for malignant cell cytology screening. RESULTS: The results of the histopathological examinations of lymph node biopsies were reactive in 25 patients and positive for malignancy in 48 patients. In 2 of 48 patients whose lymph nodes were reported to be positive for malignancy, the mediastinal lavage sample was reported to be positive for malignancy after biopsy, although it was negative preoperatively. In two patients, both the pre- and postbiopsy lavage samples were reported to be positive for malignancy. CONCLUSION: While performing dissection and biopsy during mediastinoscopy, tumor seeding into the mediastinum may occur. Long follow-up periods and large patient series are needed to determine how cytopathological examination of both fluids would affect the prognosis.
Subject(s)
Biopsy/adverse effects , Lung Neoplasms/pathology , Lymphatic Diseases , Mediastinal Diseases/diagnosis , Mediastinoscopy/adverse effects , Neoplasm Seeding , Biopsy/methods , Female , Humans , Lymphatic Diseases/diagnosis , Lymphatic Diseases/etiology , Lymphatic Metastasis , Male , Mediastinal Diseases/complications , Mediastinoscopy/methods , Mediastinum/pathology , Middle Aged , Neoplasm Staging , Prospective Studies , Secondary Prevention , Therapeutic Irrigation/methodsABSTRACT
Extrapleural hematoma is a rare clinical condition whose most common causes are blunt chest trauma, central venous catheterization and ruptured thoracic aortic aneurysm. This study aimed to present three cases that underwent video-assisted thoracoscopic surgery due to extrapleural hematoma. Etiologic factors in these cases were falls from height in two cases and a dialysis catheter placed into the right internal jugular vein in one case.
